Organization
PEARSON DRUGS NO. 4, LLC
Active
Organization
PEARSON DRUGS NO. 4, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER BRENT PEARSON (MANAGER)
(318) 445-1488
Entity
Organization
Contact information
Practice address
900 N 5TH ST, LEESVILLE, LA 71446-3544
(337) 239-4521
(337) 238-4957
Mailing address
PO BOX 3640, PINEVILLE, LA 71361-3640
(318) 619-1129
(318) 473-2879
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
870RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1217328
—
LA
01
—
1920239
NCPDP NO.
LA
Enumeration date
03/16/2007
Last updated
08/22/2020
Update your record
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